Lack of insight often allows patients with
Huntington's Chorea to escape from that mental anguish
which might be expected if they could foresee their
future. Life would be intolerable if they realised
that a comparatively early death offered the only release
from years of progressive chorea during which they would
slowly develop a dementia and probably a psychosis.
The suffering often falls instead to the families who are responsible for the care of these pathetic and distressing
The hereditary nature of the disease intensifies
the burden of anxiety for blood relations who must often
wonder if they will develop the condition themselves or
if they will pass it on to their children, which is worse.
Two responsibilities lie heavily on the medical
advisors who find such a community in their midst: firstly,
the accuracy of diagnosis necessary for the correct
application of eugenics requires very painstaking scrutiny
of family histories to establish the lines of inheritance
which may be halted or on the other hand to remove a burden
from the shoulders of the families which are proved to be
untainted. Secondly, in treatment, endeavour must
continue on a basis of prevention, cure and symptomatic
relief. Any measure of success being a seed of hope in
such a malady, where the prognosis is always regarded as hopeless and treatment of no avail.
The ensuing pages will demonstrate how these
problems have been met in Ross -shire and will indicate
the shape of the therapeutic seed which may flourish in
the fertile future of medical advance and bloom into a real and permanent cure.
Huntington's Chorea has been defined by Russell
Brain as a hereditary disorder characterized
pathologically by degeneration of the ganglion cells of the
fore brain and corpus striatum, and clinically by
choreiform movements and progressive dementia, which
usually begins in early middle life. The course is said
to be progressive, terminating in death. No form of
treatment is offered other than institutional care. I
propose to show in this paper a marked improvement in such
sufferers, sufficient in many instances to prevent the
need for certification.